Insurance

Insurance

As people with chronic diseases we often run into people, companies, or organizations. Those people or organizations often frustrate or even enrage us. I know because they often enrage me. The rules, regulations, policies, procedures and protocol are simply sometimes so upsetting it makes us want to explode with anger.

A few months ago, I needed to order resupplies for my pump. I had to answer 40 questions before I could even make my order. It was enough to drive a sane man well less than happy. Then of course when one multiplies that by the 4 companies I would talk with that day my frustration was over the top. I bet if you are reading this blog you have been there as well.

One thing that is different about my experience is that I have been on the other side of these conversations. In a former life, I used to make the very rules that frustrate us so much. I also helped people work through the maze of rules and regulations that I and others put into place. So here is some advice.

First, these seemingly ridiculous rules likely have a reason. Many seem dumb, sometimes even worse than dumb they seem manufactured to make people angry. This is not the case, but we have to acknowledge that a rule is a nothing until it is enforced and it is the often the enforcement that creates the frustration. People enforce rules, so no matter how well written rules are not always well enforced.

Second, rules are never written one at time. All health insurance rules are written as part of a package deal. Once a salesperson tried to sell me group health insurance that excluded diabetic treatments and supplies, his logic was correct, sick people drive up rates. Of course he had no idea I was a type 1 diabetic and he was at a loss when I told him to get out of my office before I had security remove him. Still this is how most of these decisions are made. Had I simply been shopping for price it might have looked attractive.

Third, there is no insurance. Health insurance companies calculate premiums based on annual losses or gains. If a group has lots of claims next year the rate will go up a lot. If they have fewer costs the price of insurance will go up less. But there is no free lunch. It all balances next year and every penny counts. One interesting fact is that most insurance companies lay off risk to other larger insurance companies. So when a company has insurance from XYZ company, that company will purchase risk insurance from different companies to protect themselves from paying the full extent of the cost of the plan.

Fourth, health insurance trend is as important and sometimes more important than actual costs. Think of trend as expected health care inflation. In years past trend has run as high as 30% and as low as 8% in my area. Trend is the automatic unofficial tax we all pay on health care costs. I have never see trend go down and I have seen it go up as much as 40%. Typical trend is 20% in this market place. That is a built in 20% increase in rates before changes are even made.

Fifth and finally, Employers attempt to lower trend by taking away benefits. But sometimes seemingly large changes yield few results. Things like raising deductibles help a little but few things will do the whole job. Managers try to do the best they can, but they know it is dammed if you and dammed they don’t. You raise or lower these things and you hope for the best.

I hope this clarifies some of the mysteries of why we get so frustrated with why we do not always understand or get along with our health insurance companies. Yes I know I still get upset, but maybe you can pass on some knowledge next time you are ready to get really angry.

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Rick

Great post, Rick. Because I am still on long-term disability I am still covered under my previous employer. The insurance used to pay 100% of costs for hospital stays. Well, my 8 day stay in April ran up a total bill of $29000 and beginning in '13, insurance pays 80%. Holy smokes! Looks like I may have to start looking for coins in between the couch cushions........
And, would you believe that each blood sugar test was billed $12?

thanks for reminding me rick about that i get ill with the questions lol

This is definitly a great post! As a former medical biller I have seen both sides of the story. I have issues with getting my supplies too. In MA its a mandatory requirement to have insurance. So ya figured that supplies would be covered, etc. They either only wanna give you one months supplies or not pay for any at all, etc. I called my insurance company a few days ago as I am having issues with getting my CGM and my test strips (currently on LTD and still covered somehow under my employers health ins when I got mixed info on the termination date). When I did use the ins through work, BCBS said I would have to pay 4000 out of pocket for the dexcom and supplies! What did my current insurance company tell me?

"we do not cover One touch ultra test strips and do not cover the dexcom". Are you for real?? I dont think they understood that the one touch ultra is a VERY popular test strips. I had to tell her that freestyle and accucheck will not work as my pump communicates with the meter for less chance of erros, etc. She didnt seem to care. I also had to explain that my pump and dexcom is a team that works with each other. She says they accept the accucheck CGM, etc. I am surprised that they will say that when these items are popular. I almost want to switch to a different masshealth plan. But a lot of my drs only take the one I was assigned to.

It is sad when people cant get ins. When I was living in NY, my diabetes suffered as I couldn't get medicaid when I was let go at my job. My A1C went to 14% before I moved back home. Its just said that its a big money maker to not have cures as that will hurt the health ins business.

Rick, I agree with the others, you clarified many things. I can't say that you took away my frustration or my disagreement with insurance companies and employers, but things are clearer now, My frustration now is with my husband's insurance "benefits". He pay's in a quarter of his pay check every week (paid weekly) for medical and dental, over $120 out of a $400 check. At this point if he paid only for the medical, we'd be able to pay his dental bills out of that money left over, as it is, we are in jepardy of loosing our dentist because the insurance company isn't paying their part. It is the same with our medical insurance, but mine pays enough to keep us at this clinic. Needless to say, each part of the insurance company is blaming someone else, and no one is getting any younger, healthier, or paid. I do understand that it is a business and they are in it to make money, but harming others to do so is WRONG.